Choosing the Right Family Planning Method: Guidance for Clients with a Method in Mind

1. Do you have a method in mind? Choosing method: Method in mind Use this page for client who has a method in mind, to check if it suits her/his needs and situation. If you do, let’s talk about how it suits you • What do you like about it? • What have you heard about it? • Check if client understands method: • Check what the client knows about the method and whether she/he needs more information. • If the client’s answers suggest misunderstanding or incorrect information, discuss and make it clear. • Ask questions tosee if method suitsclient.For example: • “Are you confident that you could remember to take a pill every day?” • “Would you be able to come back for injections?” Choosing Method If not, we can find a method that is right for you (Go to next page) Check if client would like to know about other methods. Important for choosing a method: Do you need protection from sexually transmitted infections (STIs) or HIV/AIDS? • Explain that everyone needs to consider protection from both pregnancy and STIs such as HIV/AIDS. • Encourage client to speak openly about her/his situation, her/his relationship(s) and sexual behaviour. • If client needs protection or is unsure, go to Dual Protection tab. Next Move: If no method in mind or if method in mind doesn’t suit client, go to next page. To discuss method in more detail, go to method tab. For STI/HIV/AIDS protectiongo to Dual Protection tab. CM1

2. You can find a methodright for you • No method in mind? We can discuss: • Your experiences with family planning • What you have heard about family planning methods • Your plans for having children • Protection from sexually transmitted infections (STIs) or HIV/AIDS • Your partner’s or family’s attitudes • Other needs and concerns Now let’s discuss how a method can meet your needs

3. You can find a method right for you Choosing method: NO method in mind • Helping client with no method in mind to make a decision: • Use this page to help client think about her/his situation and life and what seems most important about a method. • Discussing some of the topics at left can help the client consider different methods. You can say: • “Here are some things to consider when choosing a family planning method.” • “What is most important to you?” • “The choice is yours. I want you to be happy with your choice.” • No method in mind? We can discuss: • Your experiences with family planning • What you have heard about family planning methods • Your plans for having children • Protection from sexually transmitted infections (STIs) or HIV/AIDS • Your partner’s or family’s attitudes • Other needs and concerns • Explain that everyone needs to consider protection from both pregnancy and STIs such as HIV/AIDS. • Encourage client to speak openly about her/his situation, her/his relationship(s) and sexual behaviour. • If client needs protection or is unsure, go to Dual Protection tab. • The Special Needs tab or Appendices may help. Next Move: Go to next page to discuss what methods could suit the client’s needs. CM2

4. Comparing methods Female sterilization Vasectomy IMPORTANT!Only condoms protect against both pregnancy and STIs/HIV/AIDS Most effective and nothing to remember. Very effective but must be carefully used. Effective but must be carefully used. Fewer side-effects, permanent: Fewer side-effects: Fewer side-effects: LAM Fertility awareness-based methods Male and female condom Vaginal methods More side-effects: More side-effects: IUD Pills Injectables Implants

5. Comparing methods Choosing method • Use this page to help client compare methods and narrow down choices. • Important considerations: • Effectiveness: Depends on how much the client has to do or remember. The most effective methods require no repeated action. You can ask: • “How important is it to you that you don’t get pregnant now?” • “Do you think you can use a method that requires repeated action (such as taking a pill or getting an injection)?” • Side-effects: Side-effects of hormonal methods (pills, injectables and implants) are common at first, but may go away after a few months. The IUD may also bother some women. Discuss how client would feel, for example: “How would you feel if this method changed your monthly bleeding?” • Permanent, long- or short-term: Sterilization and vasectomy are permanent. IUD and implants can be left in place for many years. • Protection from HIV/AIDS and other STIs: Condom is the only method that protects against STIs. To help client consider options and risk, go to next page. • If client finds it hard to choose: • Find out what the client needs: To talk with partner? More information? Talk with a user? Think about it more? • Explain to clients that they can try a method for a few weeks or months to see how they like it (except sterilization, vasectomy and implants). For more information on comparing methods, see Appendices 2 and 3. Next Move: To discuss a method in more detail, go to method tab. For STI/HIV/AIDS protection,go to next page. CM3

6. Ways to avoid both pregnancy & STIs/HIV/AIDS You can decide Options using family planning: Condoms Condoms AND Another family planning method Any family planning method    WITH Uninfected partner For example: Female condoms Male condoms OR AND Some other options: AND for added protection from STIs/HIV/AIDS... Reduce your number of sexual partners: one uninfected partner is safest Other safe forms of intimacy   Delay or avoid having sex